Provider Demographics
NPI:1053303834
Name:STINEHOUR, SETH J (DPM)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:J
Last Name:STINEHOUR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 242
Mailing Address - Street 2:
Mailing Address - City:TEAYS
Mailing Address - State:WV
Mailing Address - Zip Code:25569-0242
Mailing Address - Country:US
Mailing Address - Phone:304-201-1240
Mailing Address - Fax:
Practice Address - Street 1:3954 TEAYS VALLEY RD
Practice Address - Street 2:SUITE 103
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-1526
Practice Address - Country:US
Practice Address - Phone:304-201-1240
Practice Address - Fax:304-201-1241
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10383213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2508058Medicaid
WV3810000605Medicaid
WV001720029OtherBC BS
WV3810000605Medicaid
WV4134332Medicare PIN
WVV00022Medicare UPIN